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The Depiction Of Autism Effect On An Individual’s Life In The Movie Marathon

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Synopsis

Yoon Cho-won was a person with autism attending a special school. Due to autism, Yoon was unable to express his feelings, thoughts and intentions effectively which hindered his social development. Additionally, his cognitive functions were also underdeveloped. Yoon had an interest and flair for long-distance running. After emerging 3rd in a 10km race, Yoon’s mother decided to recruit a professional coach to train him for a marathon. This analysis starts from when Yoon started his training with a coach, who was sent to the facility to serve his community service sentence. Despite his coach’s initial disinterest in training him and his mother’s later opposition towards his pursuit of running, Yoon displayed persistence and determination and completed the marathon.

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PEO Analysis

  1. Physical characteristics
  2. Sensory: functional sight, hearing, smell, touch, taste.

    Motor: fully functional; able to run and swim.

    Exhibited repetitive behaviour: arm-flapping, repeated flicking of wrist with pointed finger.

  3. Affective characteristics
  4. Yoon enjoyed running and demonstrated perseverance through completing long-distance runs. He had difficulty articulating his thoughts and feelings. He expressed his sadness through echolalic idiosyncratic speech during his mother’s hospitalisation by describing the rain in his mother’s words. He felt distress from loud arguments between his mother and coach and responded by covering his ears.

  5. Cognitive characteristics
  6. Yoon’s understanding and perception of the world was similar to a child’s. He spoke in third-person speech like how Korean children do and could not comprehend numbers, money and arithmetic functions nor follow social etiquette. His poor judgement was evident from his failure to recognise his mother drowning. Yoon had good memory functions and could recite words said to him and documentary narrations (echolalia). He displayed enough concentration to complete tasks assigned to him like drawing.

  7. Spiritual characteristics
  8. As a child, he valued his mother’s encouragement and sought it after trainings and before competitions. He had a passion for running as it gave him a sense of achievement and satisfaction, motivating him to persevere and challenge his physical limits to complete a marathon. His determination was most evident when he went against his mother’s wishes to participate in a marathon. His greatest fear was being abandoned by his mother physically and emotionally which stemmed from his childhood traumatic experience of being lost by his mother in the zoo.

  9. Institutional
  10. Yoon’s school lacked a long-term sports coach to cater to sports talents. The special school’s principal was less supportive of mom’s marathon preparation plans than job skills training it was more practical. Physical There was a small field near school enabling Yoon to warm-up and train by running laps. Later, Yoon was able to run routes outside the school compound which further facilitated his training.

  11. Social
  12. Yoon’s mother was responsible for taking care of his daily needs and planned his preparations and participations for competitions. However, she later opposed him running altogether as she believed Yoon ran due to her imposed will on him rather than genuine passion. This impeded Yoon’s marathon preparations as he was prohibited from training.

Yoon’s progress in running was initially hindered by his coach’s stigmatisation towards him. However, his later shift in attitude contributed significantly to Yoon’s running progress. However, he demonstrated his will by completing 100 laps which moved Coach to train him properly. He later personally took Yoon to register and worked closely with Yoon to train him properly, such as training him using a marathon route and teaching him how to pace himself to run longer distances. This propelled Yoon’s physical progress in running.

Impact of autism on Yoon’s life

Autism is one of the five pervasive developmental disorders. It is characterised by persistent deficits in social interaction, verbal and non-verbal communication and display of restricted, repetitive behaviour in an affected individual. Autism impaired Yoon’s verbal and non-verbal communication abilities, affecting his social interactions and relations. Many individuals with autism do not develop enough natural speech for effective daily communication and tend to “borrow” words to express their intentions and needs. While Yoon could respond to most questions, he often answered with echolalic speech, which was difficult for others to understand him. For instance, when asked separately whether he liked running or hated it, Yoon echoed ‘like it’ and ‘hate it. Like it’ respectively. Yoon’s lack of expression clarity contributed to his mother’s frustration as she could not determine whether Yoon truly liked running, and prohibited him from running. Individuals with autism also struggle with non-verbal communication through use of gestures, facial expression and eye-contact. Without non-verbal skills to facilitate verbal speech, Yoon’s ability to express himself, interact and form relations with others was limited. He seldom made eye contact while speaking or initiated conversations and could not form meaningful relationships beyond his family members and coach.

Additionally, autistic individuals cannot understand and follow social etiquette or act according to certain social contexts. Yoon did not understand the age-hierarchy system in Korea exhibited by his bowing to his younger brother and failure to use appropriate honorifics when meeting elders the first time. He also did not know how to smile at the camera. Furthermore, Yoon’s display of stereotyped behaviour such as hand-flapping made him stand out, which subjected him to further stigmatisation. Particularly, Yoon’s lack of social awareness was evident when he touched the skirt of a lady due to zebra-patterned prints, unaware of the inappropriateness of his actions. He was then subjected to physical abuse by her boyfriend and public scrutiny as onlookers perceived him as ‘crazy’ and did not attempt to defend nor correct him.

Despite autism, Yoon was able to carry out ADLs. In the movie, he was observed feeding himself during mealtimes, and was completely mobile. He did not seem to have problems with continence, toileting, dressing himself or bathing.

However, autism restricted Yoon’s executive functions and ability to perform iADLs. He was unable to make purchases as he could not understand and manage money – he was unable to perform simple calculation to determine amount of leftover change. He also depended on his mother to prepare meals. His inability to perform iADLs increased his dependence on his mother.

Yoon demonstrated restricted interests and exhibited repetitive behaviour, like others with autism. His adherence to routine was evident when he chose to sit at his usual seat despite coach’s invitation to sit beside him. Apart from running and animals, Yoon did not have interest for other activities. However, his exclusive interest in running helped him build resilience to run long distances and win medals. His resilience was evident when he persevered and ran 100 laps due to his too-literal interpretation of coach’s instructions.

PEO fit

According to Law et all (1996), the PEO model consists of three components – Person, Environment and Occupation. Each person is a unique individual taking up “a variety of roles simultaneously” and considers holistically one’s spiritual, intellectual and physical aspects. Environment is where occupation takes place and accounts for cultural, socio-economic, institutional, physical and social contexts. One’s occupation refers to “groups of self-directed, functional tasks and activities in which a person engages over the lifespan”. Maximum occupational performance is achieved when the abovementioned three components fit closely together. This PEO fit analysis will start from when Yoon starts training under his coach to the completion of his final marathon.

There was good fit between the person and occupation. Yoon had a passion in running and had been training for endurance to run long distances. There was a slight decrease in the person-occupation fit as Yoon’s mother later discontinued Yoon’s trainings, which affected his stamina. Yoon’s strong determination and passion for running was evident when he defied his mother for the first time to participate in his final marathon. The overall environment-occupation fit changed from good to poor. There was good physical environment-occupation fit as Yoon could warm-up and train by running laps in a field. He also frequented the swimming pool to develop his breathing capacity and stamina by swimming. However his social environment-occupation fit decreased from good to poor. Yoon’s coach, a former marathon champion, had the expertise required for Yoon’s marathon preparations. His mother was initially supportive of Yoon’s athletic pursuits, helping him in planning trainings and goal-setting. However Yoon’s mother later changed her stance and stopped Yoon from training and running the marathon, decreasing social and hence overall environment-occupation fit to poor, as Yoon could no longer engage in the occupation of running.

Yoon’s person-environment fit was poor initially as Yoon’s coach stigmatisation and disinterest towards him hindered his training progress. He did not believe Yoon possessed the mental resilience required for long distance running and only trained Yoon to clock community service hours. The environment-occupation fit improved significantly when coach though his interactions with Yoon, began appreciating Yoon’s personality and potential and became more vested in his training. He realised Yoon’s potential when he completed 100 laps around the field and started to see him as an individual with his own interests when Yoon gave an apt description of his favourite animals when coach asked him what he liked. Yoon’s made better progress when coach conducted running sessions using real marathon routes, increasing physical environment-occupation fit. Yoon’s coach effectively taught him how to pace himself by drawing parallels to how fast animals run – something Yoon was familiar with – increasing person-environment fit.

The person-environment fit suffered another blow when Yoon’s mother started to question Yoon’s interest in running as Yoon’s echolalic responses (mentioned in impacts of diability) confused her. She thought Yoon’s pursuit of running was out of her desire for him rather than his genuine passion. Without mom’s support, Yoon could not train even if him and his coach were willing, which in turn decreased social environment-occupation fit.

Reflection

As people with autism lack the ability to express their thoughts and feelings, I learnt that patience is key to interacting with a person with autism. As they are generally less responsive to social stimuli, I need to be more proactive and patient when engaging with my future clients with autism as an occupational therapist. It is important to not rush the process as people with autism take time to open up to those around them, as illustrated by the gradual progress of Yoon’s and his coach’s relationship. When speaking to my clients, I also need to use simple language in a direct manner, like how Yoon’s mother uses simple words and phrases with Yoon, so they may understand. It is also useful to relate new concepts to things they have interest in and are familiar with so they can comprehend better. For instance, Yoon could not pace himself until his coach compared it to how fast wild animals run in specific situations. In the movie, Yoon frequently used echolalic speech to convey his intent indirectly, such as describing the. As an occupational therapist, I will try to read such cues to understand my client’s wants and interests. In addition, I will remind myself that progress is possible with patience – Yoon was finally able to perform simple calculations involving money towards the movie’s ending.

Another noteworthy point was Yoon’s mother’s overprotective approach towards Yoon. Yoon’s mother’s love for Yoon spawned into an obsession as she based her life around taking care of him and controlled him so much he “could not even pee without her permission” in coach’s words. This resulted in her neglect of her husband and other son. As an occupational therapist, I will keep in mind to work closely with my client’s family and caregivers as well to ensure my client has appropriate care, but still has opportunities to develop more independence to lighten their load.

Lastly, the film highlighted the importance of familial encouragement for persons with autism through Yoon’s continuous seeking of positive affirmation from his mother. However, Yoon’s mother reflected that she pushed him too hard, unaware that his fear of abandonment prevented him from voicing his tiredness as she never let him know it was okay to feel fatigue and take a break. Hence, it is equally important to let individuals with autism know it is okay to feel tired and make mistakes sometimes, so they do not feel over-pressured.

Overall this was a comprehensive movie to watch in understand how autism affects an individual’s life, his relationships with others and those around him.

18 March 2020

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